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2019 EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older.

School of Health Sciences, University of Southampton, Southampton, UK. Department Care I, Musculoskeletal System & Neurology, Dutch National Health Care Institute, Diemen, The Netherlands. EULAR Standing Committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland. EULAR Young PARE, Zurich, Switzerland. Slovak League Against Rheumatism, Piestany, Slovakia. Medicine for Older People, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Department of Rheumatology, Aarhus University Hospital, Arrhus, Denmark. INSERM U1153, Paris Descartes University, Reference Center for Genetic Bone Diseases - Department of Rheumatology, Cochin Hospital, Paris, France. Department of Orthopedics and Trauma-Surgery, Medical University of Vienna, Vienna, Austria. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. Rehabilitation, Physical Medicine and Rheumatology, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Timisoara, Romania. Section for Outcomes Research, Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria. Department of Rheumatology, VU University Medical Centre Amsterdam, Amsterdam, Noord-Holland, The Netherlands. Centre for Biomedical Research, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal. Department of Balneology, Rehabilitation and Rheumatology, 'Victor Babes' University of Medicine and Pharmacy, Timisoara, Timisoara, Romania. Internal Medicine 3, Division of Rheumatology, Medical University Vienna, Vienna, Austria. Trauma & Orthopaedics, University Hospital Southampton NHS Foundation Trust, Southampton, UK. Day Hospital, Alicante General and university Hospital, Alicante, Spain. Section for Outcomes Research, Centre for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria tanja.stamm@meduniwien.ac.at. Ludwig Boltzmann Institute Arthritis and Rehabilitation, Vienna, Austria.

Annals of the rheumatic diseases. 2021;(1):57-64
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Abstract

OBJECTIVE To establish European League Against Rheumatism (EULAR) points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older. METHODS Points to consider were developed in accordance with EULAR standard operating procedures for EULAR-endorsed recommendations, led by an international multidisciplinary task force, including patient research partners and different health professionals from 10 European countries. Level of evidence and strength of recommendation were determined for each point to consider, and the mean level of agreement among the task force members was calculated. RESULTS Two overarching principles and seven points to consider were formulated based on scientific evidence and the expert opinion of the task force. The two overarching principles focus on shared decisions between patients and non-physician health professionals and involvement of different non-physician health professionals in prevention and management of fragility fractures. Four points to consider relate to prevention: identification of patients at risk of fracture, fall risk evaluation, multicomponent interventions to prevent primary fracture and discouragement of smoking and overuse of alcohol. The remaining three focus on management of fragility fractures: exercise and nutritional interventions, the organisation and coordination of multidisciplinary services for post-fracture models of care and adherence to anti-osteoporosis medicines. The mean level of agreement among the task force for the overarching principles and the points to consider ranged between 8.4 and 9.6. CONCLUSION These first EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older serve to guide healthcare practice and education.

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